Sodas: The Good, The Bad and the Ugly

I'm in DC visiting my brother right now. I've observed the dietary habits of my eleven year old nephew these past few days. I'm concerned with what I'm seeing. I mentioned some things about the sodas he's been drinking. He asked "what's wrong with drinking sodas?"

In the last 100 years, sodas have become one of the most commonly consumed beverages. They are readily available and can be found anywhere. They are available in every store, restaurant school and public venue.

The reason why they have become so ubiquitous is because they taste very good. I enjoy an occasional soft drink. There's nothing wrong with drinking them on occasion and infrequently.


Some cities have enacted laws to curb their consumption. New York City for example has banned the sale of sodas in containers larger than 16 ounces. Opponents have argued that individual rights and choices are being violated. I will not get into the legal aspects of this. I don't believe that this is something the government should be involved with anyway. I will simply state the facts.


So what are the issues with sodas? They taste so good. Well, here are some health concerns:

• Obesity
• Diabetes
• Osteoporosis
• Tooth decay
• Strokes
• High Cholesterol
• Gastro-esophageal reflux disease

The reason why they are so bad for you is primarily because of the high concentration of refined sugars and because of the the acidity of these products. There are different biochemical mechanisms why the issues mentioned above are more likely. The mechanisms are beyond the scope of this blog. I may discuss them in more detail in future writings.

A poster I found online. I'm not sure about the asthma link.

These are some of the issues with regular sodas. I'm not even talking about the popular energy drinks. These are certainly much worse for you and account for a dramatic increase in emergency room visits in recent years. Perhaps I'll write about these in another blog.

I hope this provides enough rudimentary information that may help you decide to reduce or eliminate your soda intake. Speak to your health care professional for advice.

What is an abcess?

An abscess is a collection of pus. It occurs as a result of an inflammatory response to bacteria, parasites or foreign bodies such as a splinter. It's the body's way of responding to a threat. A large number of white blood cells will be drawn into the area in an attempt to kill or eliminate the threat. A wall of cells forms around the source of infection in an attempt to isolate it. This can occur anywhere in the body.

A tooth abscess is simply an abscess that forms in the jaw bone surrounding an infected tooth. This most commonly occurs when the pulp (the space within each tooth that contains nerves and blood vessels) becomes infected. The bacteria and necrotic tissue then leaches out at the apex of the root. The pulp can become infected when untreated decay, cracks or periodontal disease occur.

You may notice pain when you bite or push on the affected tooth. In many cases the pain can become incredibly severe. Abscesses occur on teeth that are dead. So, you may not notice any temperature sensitivity.

Sometimes you may not experience any pain whatsoever. This occurs when the pus is draining through a "bump" on the gum in close proximity to the root of the tooth. The reason why it may not hurt is because the draining of the pus is preventing the tissues from expanding like a water balloon. It's as if the water balloon has popped. This is good and bad. Obviously it's good because there isn't any pain. But it's bad because people aren't prompted to do anything about it.



Tubes placed to allow drainage



If you suspect that you have an infection, get it checked out immediately. Infections can significantly worsen in an extremely short period of time and can become life-threatening. Yes, life threatening! There are a couple reasons why. First, the swelling can become so severe that it can compromise your airway. Breathing is kind of important. I certainly like to breath. A second reason why it could become life-threatening is because the bacteria is circulating throughout your blood stream. You run the risk of becoming septic. This is when the concentration of bacteria has become so severe that it has overwhelmed your ability to fight it off. People have succumbed to septic shock originating from odontogenic (tooth borne) infections.

There are a several treatment options. If the tooth is salvageable, then simply removing the bacteria and necrotic tissue from within the tooth is indicated. After the internal part of the tooth is thoroughly cleaned out, it is sealed in order to prevent migration of bacteria back into the tooth. We then rely on the immune system and antibiotics to remove the bacteria inside the the bone. Most people refer to this treatment as a root canal. By the way, root canals don't hurt. A second option should only be considered when the tooth is not salvageable. In these cases, the only remedy is the removal of the offending tooth. A third treatment is only necessary when there is significant swelling. Incision of the lump of pus will allow it to drain. It sounds gruesome to cut into a lesion, but patients get significant relief immediately.



Dog afflicted with a tooth abcess



Many people believe that antibiotics alone will solve the problem. This is only a temporary fix. The only solution is the complete removal of the source of infection with either a root canal or an extraction. Antibiotic treatment without removal of the source is encouraging the development of antibiotic resistant strains of bacteria.

As soon as you notice an unusual bump, get this evaluated and treated right away. Delays in treatment can result in dire consequences.

Are Your Teeth Getting Longer?

Are your teeth starting to look longer as you age?

Long appearance of teeth due to aggressive brushing

Ever hear the phrase “long in the tooth?”  Well, this phrase was originally used to refer to older people and horses.  Unlike humans, horses teeth continue to grow as they age, which indicates that horses with long teeth are older.  However, human teeth don’t continue to grow with age, but they can appear to look longer as people age.  There are many factors that can explain why teeth appear to lengthen as people age….

·        Gum Recession –  causes of gum recession are as follows…

o   Vigorous Hygiene (bushing too hard)

o   Bruxism – or grinding your teeth (which can also shorten teeth)

o   Extensive orthodontic treatment

o   Trauma – such as an accident

·        Periodontal Disease – In the advanced stages of gum disease, or gingivitis.  This is an infection in the gums and underlying bone.  When left untreated, bacteria begins to destroy the underlying bone and gum tissue leaving teeth mobile, or wiggly, while exposing the root of the tooth. Over 70% of Americans have some form of gum disease.  This can only be treated by your dentist.  This is also the number cause of premature tooth loss and can cause many health concerns, including cardiovascular problems.

·        Habits

o   Chewing ice

o   Smoking or using smokeless tobacco

o   Certain recreational drugs

It was once thought that losing our teeth was part of the natural aging process.  However, we now know that with proper care, healthy habits, healthy diet and regular dental visits premature tooth loss can be a thing of the past. If you have noticed you are starting to get “long in the tooth” talk to your dentist about your options. Dentistry has come a long way and there are many options to help you maintain a youthful smile for your entire life!

Written by: Carrie Owens

Botox Parties: Are They Safe?

Most people want to stay young. Botox is a great tool in helping you keep your face young.

In recent years, BOTOX® parties have become quite trendy. Botox parties are sometimes held in private homes and are not much different than Pampered Chef® parties. They are also held in beauty salons and in clinical settings such as a doctor's office.

This topic has become quite heated. There are many so called "beauty experts" that hold these parties. The problem here is that these self proclaimed experts have very limited knowledge of the facial anatomy. They see a wrinkle and proceed to simply administer Botox in these areas. Botox inhibits muscular contraction. So, when a muscle is injected, the muscle will relax. This can provide the desired effects. However, when the wrong muscles relax, the facial features may appear to be deformed or asymmetrical.

Many doctors including myself discourage the administration of Botox in an uncontrolled setting performed by inadequately trained people. Some things to consider are:

• Does the provider have a thorough understanding of the facial anatomy?
• Does the provider have a thorough understanding of the medicaments being administered?
• Does the provider have adequate record keeping and follow up protocol?
• Do they review your medical history?
• Does the provider provide informed consent?
• Are there any privacy issues?
• Does the provider have a license or credentials to administer medicaments?
• Does the provider know how to deal with complications?
• Is there alcohol being consumed at these parties?
• Is the product being administered counterfeit Botox?
• Is the facility clean and safe?

In summary, Botox parties are very safe in the hands of competent and credentialed practitioners. However, in the hands of a "beauty professional" at a random party or at the neighborhood salon offering cheap prices, you are rolling the dice.

Cold Sensitive Teeth

One of the most frequent questions I get is about sensitive teeth. There are many potential reasons for sensitivity. Sometimes this could be a minor nuisance, whereas in other cases, this could be much more serious.

Here are a few reasons for cold sensitivity:

• Metal restorations: Many people have fillings, crowns, bridges and other metallic restorations. The reason why there is often cold sensitivity with these types of restorations is that metal conducts temperature rather well. So any temperature change is readily noted.
• Gum recession: When gums recede, the root surfaces of the teeth become exposed. These exposed root surfaces can be very sensitive to cold because there is no enamel covering the surface.
• Decay: A surface that has decay is often cavitated. The break in the continuity of the enamel makes the tooth much more sensitive to cold.
• Teeth with enlarged pulps: There are nerves and blood vessels inside every tooth. The space within the tooth that they occupy are called the pulp. Younger people have larger pulps. As we age, the space gets smaller. This means that the pulp of younger teeth are closer to the surface of the tooth. In other words, there is less tooth structure insulating the tooth. So in the absence of other issues, younger teeth are more likely to be sensitive to cold.
• Temporary restorations: Temporary restorations simply do not fit as well as permanent restorations and are very likely to be cold sensitive. Click here to see a previous blog on temporaries.
• "High" restorations: When you bite down, if there is a spot on a tooth or restoration that makes premature contact, it will cause more force to be applied to the tooth repetitively. The extra force on a single tooth will make it become sensitive to biting pressure. In addition, the tooth will also become more sensitive to cold. Fortunately, this can be fixed easily. A small amount of restorative material may just need to be polished away to decrease the biting pressure.
• Defective restorations with open margins: If there is a gap in the interface between the restoration and a tooth, cold sensitivity is likely to become an issue. This is because of two things. The first is that there is simply a gap and the exposed tooth structure is quite sensitive. The second reason is that bacteria migrate into the spaces and infect the tooth structure. The decay that occurs is very toxic to the pulp. When the pulp becomes infected, the nerves become hypersensitive.
• Trauma: When there is trauma to a tooth, the nerves and blood vessels within a tooth become inflamed. Since they are in a confined space with no room to expand, the pulp becomes incredibly hypersensitive.
• Infected pulp: When this occurs, the pain will be incredibly intense. The pain may also linger for some time after the source of cold is removed. In addition, the tooth may experience a throbbing sensation.

If you are suffering from cold sensitivity get the advice of your dentist. Do not ignore the problem because it may lead to more complications and expense.

Dry Mouth

It’s winter time and cold and flu season is upon us. What does this mean

for you? Well, with the drier air and stuffy nasal passages some people may

notice that they are experiencing a dry mouth for a number of reasons.



What is dry mouth? Dry mouth is a condition in which saliva is produced in

limited amounts. The medical term for dry mouth is xerostomia. Xerostomia

may seem like a minor problem but for people who experience it, it is a

nuisance and can also cause problems. Common problems associated with

dry mouth are increased risk of tooth decay and less enjoyment in food.

Some people complain of a discomfort caused by dry mouth, and say it is

comparable to having a mouthful of cotton.

Saliva helps to prevent tooth decay by limiting the amount of bacterial growth

and washing away any extra food particles. When saliva production is

reduced these benefits are diminished. Moreover, saliva helps people to enjoy

the taste of the their food and swallow their food more easily. People who

experience dry mouth often complain that their food is not as pleasurable and

eating is somewhat uncomfortable.

The most common causes of dry mouth are…

• Medications – This includes prescriptions and over-the-counter

medications. Many cold medications, including antihistamines and

decongestants can cause dry mouth.

• Mouth breathing – Allergies, a deviated septum, chronic sinus issues,

or unusually large adenoids can cause make people breath through

their mouths rather than through their noses. This will obviously

increase airflow through the mouth and will thereby cause the mouth

to become unusually dry.

• Illnesses – Many chronic and acute illnesses can dry out the mouth.

Diabetes for example is a chronic illness often associated with dry

mouth.

• Cancer treatments – especially radiation treatments. Radiation can

destroy the salivary glands and thereby decrease salivary output.

• Recreational drugs – Some common drugs include alcohol, cocaine,

marijuana and nicotine. Even excessive caffeine can cause issues with a

dry mouth.

People who experience dry mouth should consult their dentist and doctor

for possible treatment options. Possible treatment options include various

types of salivary substitues, sugar-free chewing gum specifically made for

dry mouth, mouth sprays and rinses. If medication is the cause, possible

alternative medications can be explored. For some, mouth breathing may be

due to anatomical reasons, in which case surgery may be an option. If mouth

breathing is due to allergies, finding the proper allergy medications may be

beneficial. Some over-the-counter medications for colds and allergies can

cause dry mouth. It is important to work with your doctor or dentist to find a

solution that is right for you.

Written by: Carrie Owens

All I Want For Christmas is...My Two Front Teeth

All I Want for Christmas is…My Two Front Teeth

More than likely you have heard the lyrics to the Christmas song “All I Want for Christmas is My Two Front Teeth.” While this song is written from the perspective of a small child who has lost their primary teeth (baby teeth), sung with a slight lisp, and meant to be humorous, the song is right on the money when it comes to missing teeth. Every year I hear this song and think about how this song really hits on the inconveniences of living without teeth.

Few things can ruin a person’s self-esteem and confidence as quickly as losing a tooth, especially in the front. Often people take their teeth for granted until they lose them. The cost of preventative care and restorations can be minimal when compared with the cost of replacing teeth or the inconvenience or embarrassment of living without them. 
 

People are often more concerned about losing teeth in the front of their mouths, because people can see them. However, they don’t seem as concerned about losing teeth in the back. All teeth are important for different reasons. It is important to remember that the mouth is the beginning of the digestive tract. Our digestive tract is how we nourish our bodies. Moreover, food and dining serve as a great source of pleasure at many social functions and in our lives.

Teeth serve a variety functions:

1. Chew and digest food

2. Help us enunciate our words and communicate

3. Help us to smile

4. Serve as lip and cheek support

5. In more primitive times and even in emergency cases, teeth are used for defense

6. Provide a multitude of social advantages

Every time we lose a tooth the remaining teeth must pick up the slack. Think of teeth like studs in a wall. When a stud is removed the remaining studs bear much of the weight and over time the integrity and strength of wall is diminished and eventually those remaining studs succumb to that added stress. Losing teeth is much like this. Every tooth is important and every tooth serves a purpose even if it cannot be seen when a person smiles.

You may be like many others who believe replacing teeth in the back is not a necessity if they cannot be seen. Consider this…If you lose all or a majority of your teeth in the back (posterior teeth) and you don’t replace them you will be relying on the teeth in the front to“chew” your food. Front teeth (anterior teeth) are not meant to chew food, but rather to bite off bite-size portions. Eventually this added stress and misuse of the front teeth will wear them down which will more than likely lead to premature tooth loss.

The next time you hear the Christmas song “All I Want for Christmas is My Two Front Teeth” think about how important your teeth are. Think about how that child in the song, during the wonderment of Christmas amidst the toys, candies and goodies …wants teeth!

Written by: Carrie Owens